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9210 The ICPC Referral Packet

 

A comprehensive ICPC referral packet is required to avoid a delay in the ICPC process. Complete information allows the receiving state to assess the prospective placement family's ability to care for the child's (children's) specific needs. Likewise, this information will aid the family in making an informed decision regarding their ability to care for the child.

 

The Kansas compact administrator or designee may request additional information on the child.

 

The National Electronic Interstate Compact Enterprise (NEICE) system shall be used to enter ICPC paperwork and forward documents to Kansas ICPC. The referral packet for parent, relative, foster care, and residential placements shall include the following:
 

  1. The ICPC 100A (PPS 9130) Interstate Compact request form shall be completed for each child. The case will be entered in NEICE which generates the ICPC 100A. For cases not entered in NEICE, the CWCMP retains a copy, and one copy is included in the referral packet. This form is used to request and approve all placements from Kansas.

  2. A comprehensive cover letter explaining the child’s situation and the reasons for requesting placement with a family in another state. Special needs or specific issues that need to be addressed with the family shall be noted.

  3. Social history to include child's current functioning, special needs, the reason the child entered DCF custody and as much information on the birth parents and siblings as possible. (See Appendix 3A for suggested social history outline.)

  4. Journal Entry/Court Order signed by the judge granting custody to DCF. (If these documents are not signed, they will be returned to the Child Welfare Case Management Provider for the judge's signature.)  Include a copy of the initial custody order and a copy of the most recent court order (within the past year) showing continued custody.   For a Regulation 7 sample court order, see Appendix 9-G.

  5. Case plans:  the initial and most current.

  6. PPS 9140, Financial/Medical plan form, shall be completed by the DCF worker or the Child Welfare Case Management Provider with the assistance of the DCF worker.

  7. Copy of birth certificate. If the birth certificate is not available, include copy of birth certificate application. Upon receipt of the original birth certificate; forward a copy of the document to the ICPC Office.

  8. Copy of the social security card or written verification of social security number from Social Security Administration. If child does not have a social security card, attach a copy of the application verifying that a social security card has been requested.  Upon receipt of original social security card forward a copy to the ICPC Office.

  9. If available, include child's medical history, including immunization records, psychological reports, and school records.

  10. Statement of Case Manager/ICPC Potential Placement, form PPS 9100.  This form shall contain the CWCMP case manager’s signature.

  11. Regulation 7 referrals shall include the documentation required in the above    section 9210.1.a through 9210.1.i, and the following:

    1. Signed Regulation 7 court order.  See Appendix 9-G for a sample regulation 7 court order, and

    2. Completed PPS 9145 (ICPC 101) form for each child.

  12. For Psychiatric Residential Treatment Facility (PRTF) placements, include the following:

    1. Letter of acceptance from the PRTF.

    2. A statement acknowledging the responsibility to pick up and return the child to Kansas in the event of a disruption.

    3. Court order with a Delinquent Adjudication Statement per ICPC Article VI. Institutional Care of Delinquent Children.

    4. Current Mental Health treatment plan

  13. Referrals for public adoptions shall include the documentation described in the above section 9210, and the following.

    1. Medical and Genetic Information.  PPS 5340, Part I, II, and III forms shall be completed by the birth parents. However, if the birth parents are unavailable, the Child Welfare Case Management Provider may complete and sign these forms and send an affidavit explaining that birth parents were unavailable to complete the forms.

    2. Voluntary relinquishment signed by birth parents and accepted by DCF or a journal entry terminating parental rights signed by the judge.

    3. Journal Entry documentation reflecting compliance with the Indian Child Welfare Act.

    4. If applicable, adoptive resource home study completed prior to the ICPC adoption request.  Requests will be forwarded to the receiving state requesting an updated case specific adoption home study.

If a pre-approved adoptive family is moving out-of-state, include the previous adoptive home study in the referral.

 

Should the child become free for adoption after ICPC has already been initiated, a new 100-A (PPS 9130) shall be completed requesting an adoptive home study. Attach three copies of the new case plan and legal documentation indicated above and forward to Kansas ICPC.  

 

For adoptions finalizing in Kansas, please see Appendix 5R, Checklist for Request for Consent to Adopt.